Is benzoyl peroxide safe for treating acne vulgaris?

Studies have shown that BP (short for benzoyl peroxide) is considered to be safe and effective against superficial inflammatory lesions as it has the ability to rapidly suppress the P. acnes (i.e. short for Propionibacterium acnes, a bacterium that grows and flourishes under certain condition and is the main culprit for inflammatory acne) present in our skin.

Also, benzoyl peroxide has the advantage of not being associated with antimicrobial resistance which makes it often used in combination with other oral or topical acne antibiotics to increase its efficacy and to minimize resistance. In fact, studies have shown that benzoyl peroxide if used in combination with other topical acne treatments such as topical erythromycin or clindamycin will be even more effective and better tolerated than either BP or the topical acne antibiotic alone.

The only drawback of using benzoyl peroxide for some people is due to its concentration-dependent stinging, dryness, irritation of the skin, contact dermatitis, and bleaching fabric or hair where it comes in contact with, what ensue is seen as redness, scaling and itching, or burning. Nevertheless, the irritant and contact reactions in our skin usually occur within the first few days (some may to weeks) of acne treatment and shall improve with continued use. However, benzoyl peroxide is known to bleach hair, clothes, and bed linens which we should take this risk factor into consideration when seeking for our acne solutions.

We may want to know that:

• Benzoyl peroxide is available in a variety of formulations and concentrations, usually ranging from 1% to 10%. The gel formulations are preferable than creams and lotions due to its stableness and consistency in releasing the active ingredient.

• If our skin tends more toward dryness (especially on our face), we should start with a lower concentrations of benzoyl peroxide products. As with all topical acne medications, it is suggested that benzoyl peroxide products should be applied to the entire affected area and not just those visible lesions (i.e. a mark in the skin). From the acne clear and acne care point of views, we should use it in the morning and evening.

• Benzoyl peroxide cleansers are also useful for application to large areas on our body, such as our chest and back and can be used conveniently in the shower too.

• On thing we may not aware is that benzoyl peroxide works exceptionally well when used in combination with a topical retinoid. For better acne control and acne treatment purposes, we should use the retinoid in the evening and benzoyl peroxide or a topical acne antibiotic or a combination of benzoyl peroxide/topical acne antibiotic in the morning as it helps to minimize the risk of inactivation of the retinoid. Try to put clothing on first, especially if they are to pass over our face as this helps to minimize the possible bleaching of the fabric that may ensue through contact. It is good to know that newer and more sophisticated formulations are being developed for these products to be used simultaneously without increased irritant reaction or inactivation of any of the active ingredients.

What follows is a list of benzoyl peroxide formulations for reference:

BenzaClin - 1% clindamycin/5% BP gel (water base)
Benzamycin - 3% erythromycin/5% BP gel (alcohol base)
Benzac AC - 2.5%, 5%, 10% gel(emollient, water base)
Benzagel - 5%, 10% (alcohol base)
Benzashave - 5%, 10% shaving cream
Brevoxyl - 4.8% creamy wash; 4.8% gel
Desquam-E - 2.5%, 5%, 10% gel (emollient, water base)
Triaz wash, pads, gel - 3%, 6%, 9%
Zoderm - 4.5%, 8.5% in urea base